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Review
. 2017 Jul;17(7):51.
doi: 10.1007/s11892-017-0875-2.

The Case for Diabetes Population Health Improvement: Evidence-Based Programming for Population Outcomes in Diabetes

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Free PMC article
Review

The Case for Diabetes Population Health Improvement: Evidence-Based Programming for Population Outcomes in Diabetes

Sherita Hill Golden et al. Curr Diab Rep. .
Free PMC article

Abstract

Purpose of review: The goal of this review is to describe diabetes within a population health improvement framework and to review the evidence for a diabetes population health continuum of intervention approaches, including diabetes prevention and chronic and acute diabetes management, to improve clinical and economic outcomes.

Recent findings: Recent studies have shown that compared to usual care, lifestyle interventions in prediabetes lower diabetes risk at the population-level and that group-based programs have low incremental medial cost effectiveness ratio for health systems. Effective outpatient interventions that improve diabetes control and process outcomes are multi-level, targeting the patient, provider, and healthcare system simultaneously and integrate community health workers as a liaison between the patient and community-based healthcare resources. A multi-faceted approach to diabetes management is also effective in the inpatient setting. Interventions shown to promote safe and effective glycemic control and use of evidence-based glucose management practices include provider reminder and clinical decision support systems, automated computer order entry, provider education, and organizational change. Future studies should examine the cost-effectiveness of multi-faceted outpatient and inpatient diabetes management programs to determine the best financial models for incorporating them into diabetes population health strategies.

Keywords: Cost-effectiveness; Diabetes mellitus; Diabetes prevention; Inpatient diabetes; Multi-level diabetes interventions; Population health.

Figures

Fig. 1
Fig. 1
Diabetes population health improvement framework
Fig. 2
Fig. 2
A conceptual model for systems interventions to improve the quality and safety of inpatient management of hyperglycemia and diabetes. (Adapted with permission from: Draznin et al. Diabetes Care, 2013;36(7):1807–1814; permission conveyed through Copyright Clearance Center, Inc.) [103]

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